July 2013

The first-ever international guidelines for treating hepatitis C in people who inject drugs has been published in the journal Clinical Infectious Diseases ahead of World Hepatitis Day on 28 July.

The guidelines are part of a supplement, “Prevention and Management of Hepatitis C Virus Infection Among People Who Inject Drugs: Moving the Agenda Forward”, developed by researchers from the Kirby Institute at UNSW, in collaboration with colleagues from the International Network on Hepatitis Care in Substance Users (INHSU).

Burnet researchers, Dr Esther Aspinall, Joe Doyle and Professor Margaret Hellard contributed to a key article in the supplement, “Treatment of hepatitis C virus infection among people who are actively injecting drugs: A systematic review and meta-analysis.”

According to the new recommendations, the burden of liver disease could be dramatically reduced by increasing treatment for hepatitis C infection among people who inject drugs.

In Australia, 226,000 people are living with chronic hepatitis C and over 10,000 new cases are reported every year. Hepatitis C can lead to serious liver complications such as liver failure or cancer, which are associated with considerable costs to the health care system. Although almost 80 per cent of all infections occur among people who inject drugs, only one per cent of these people currently receive treatment.

“Treatment for hepatitis C infection among people who inject drugs remains unacceptably low,” Dr Jason Grebely, Senior Lecturer at the Kirby Institute, UNSW, and co-lead author of the recommendations said.

“Clinicians have been hesitant to recommend treatment in this population because of a lack of understanding about how lifestyle factors may impede successful treatment.”

But research supporting treating hepatitis C in people who inject drugs has shown that treatment can be very successful when barriers are addressed within a supportive environment.

“Reducing the significant burden of liver disease related to hepatitis C in Australia and internationally will require improved assessment and treatment of the population most affected: people who currently inject drugs and those who have injected drugs in the past,” Dr Philip Bruggmann, President of INHSU said.

“By providing appropriate care to this group, we can reduce the burden of hepatitis C-related liver disease in this vulnerable population and slow the spread of this world-wide epidemic. These new recommendations serve as a first step towards elimination of hepatitis C.”

Treatment for hepatitis C infection among people who inject drugs remains unacceptably low

Dr Jason Grebely, co-lead author, Kirby Institute, UNSW